As a follower of debates around health care policy, I often feel as if I’m watching three blind mice fumble about, trying to identify this enormous behemoth in their midst.

“It’s all about expansion of insurance coverage!” shrieks one, “We need to make sure that everyone has coverage under an insurance plan, one purchased in the marketplace. Punishing them if they don’t, just like car insurance.”

“No,” screams another mouse, “What good is insurance if it only buys you shoddy care? We need to invest in community health clinics, so that everyone has access to the primary care that they need!”

“Au contraire,” the third mouse spoke up, “The problem is rising costs, because people are not paying into the system, taxpayers end up bearing the brunt. Society should just let the uninsured die.”*

All three mice, like the back and forth between the President, Democrats and Republicans, bicker furiously to extend their particular perspective to the whole. But, one thing they can all agree on: something has to give. And, because the word of the day, post-Labor Day, has been about jobs after the summer’s craze for deficit reduction, even Democrats are cozying up to cuts to Medicare and Medicaid, in a manner previously unthinkable, ostensibly, to fund job creation.

Obama, in his jobs speech to Congress last week, said spending cuts would fund his $47 billion plan to resuscitate the U.S. economy, including “modest adjustments to health care programs like Medicare and Medicaid.” He added, “We have to reform Medicare to strengthen it.” What that means exactly is still unclear, but he hinted, ominously, that the cuts will be deeper even than the $1.5 trillion that the Congressional Supercommittee is charged with slashing.

Cuts to Medicaid and Medicare would be devastating to communities of color. People of color comprise more than half of the 50 million Medicaid recipients. As Amara Nwosu wrote previously, a report released last month by the Alliance for a Just Society found that existing disparities in health care access and quality of care would be exacerbated if Medicaid was slashed.

What Obama and Congress don’t acknowledge is the beast in the room: the increasing number of people losing coverage or any recourse to health care because of being jobless, most of them people of color. A new report by the Commonwealth Fund found that the number of underinsured adults increased by 80 percent, from 16 to 29 million, since the start of the Great Recession. Lacking or having inadequate coverage is often due to the loss of a job, because most in this country get our health insurance through our employer. Moreover, one out of every two adults, that’s 81 million people, were either underinsured or uninsured in 2010.

Shocking, but not surprising. We know more people of color are unemployed than whites and for longer periods of time. Being jobless leads not only to economic woes, but also emotional and physical ones. I wrote previously about how incidents of chronic health conditions increase dramatically for those who lose their jobs. We also know that neighborhoods with the highest foreclosure rates, mostly residents of color, correlate with poor health outcomes.

And, this monster is growing, despite itself, in dimensions unthinkable by the blinded mice. The Affordable Care Act changed health care financing by moving pots of money previously allocated to safety net hospitals, to cover their debt incurred by treating uninsured patients, towards expansion of private insurance coverage. As a result, across the nation, hospitals and emergency room departments, places of last resort care for the millions of jobless and uninsured as well as recent and undocumented immigrants, are closing their doors. Guess where most of these hospitals are located? You got it: urban communities of color, mostly of those living in poverty.

If we’re talking about jobs, we know that investment in health care creates more opportunities, particularly for workers of color who can’t find work in our shrinking manufacturing base. Numbers crunched by our friends at the Health Rights Organizing Project and the Political Economy Research Institute found that Medicaid spending actually creates jobs and stimulates the economy.

So, let’s address the elephant in the room: Medicaid + Medicare + increased support for community clinics, as well as safety net hospitals = a healthy, happy and prosperous populace. Take away any of the factors of the equation and you get the ugly monster that we’re looking at now, a Congress with blinders on, and a President too mousy to speak up.

* A popular opinion, apparently, among attendees of last night’s GOP debate.

via RaceWire

It was the best of times, it was the worst of times…it was the spring of hope, it was the winter of despair…we had everything before us, we had nothing before us.*

The Obama administration enacted the $787 billion American Recovery and Reinvestment Act (ARRA) back in February, the largest boon to public spending and the safety net since the New Deal, and yet economic conditions are the worst it’s ever been for people of color and single moms. Unemployment is skyrocketing close to double digits, at 9.7% for August 2009. New Census data released recently showed an increase in poverty from 12.5% to 13.2% this past year, meaning an additional 2.6 million persons now live in poverty. Certain groups experience deepened poverty rates more than others, according to the Economic Policy Institute:
• Latinos and Asians had marked increases in their poverty rates, by 1.6 and 1.4 points, respectively.
• Over one third of all Black children and almost one third of all Latino children lived in poverty in 2008.
• Nearly a quarter of all families headed by single moms lived in poverty, or 3.6 million families, in 2008.

Tracking funds from the Recovery Act has proven to be difficult because there is no centralized, authoritative source of where the money is going to and what it’s being used for. Currently, information about ARRA funds are dispersed across the federal recovery.gov website, state stimulus czars, and watchdog groups. Recipients of monies are required to report on their activities and how many jobs they’ve created because of it by October 10. But, information will only slowly trickle out to the public. Even then, there is no requirement for recipients to race or gender their data, so we have no way of knowing how much of the recovery benefits those most impacted: people of color and single moms.

We have been following the recovery and its promise to stimulate the economy while protecting the planet and its peoples through the creation of green jobs. Watch this page on October 13 for the release of our Green Equity Toolkit, ideas and resources for community and labor advocates on how to create equity in the emerging green economy. If we are to follow the directive of ARRA and the subsequent Office of Management and Budget (OMB) guidance to help those most impacted by the recession, then we must make race and gender equity key in our planning and practices around green job creation. The toolkit will help us do that.

Our initial research into recovery allocations in Los Angeles County brings to light some concerns. Los Angeles County, like many in this country, is cleft by a racial wealth divide into two types of cities: poor and rich. Poor cities of the county–half of the residents of the City of Los Angeles are people of color and one in five live in poverty–are receiving a quarter of the recovery dollars per poor person, as compared to rich cities. We designate cities such as Santa Monica and Beverly Hills as rich cities in the county, where more than 70% of the population are white and the poverty rate is well below the national average.

This is the worst economic downturn our country has experienced since the recession of the early 1980s and flirting dangerously to parallel the Great Depression of the 1930s. What will our generation remember when we look back at this time? Did we seize the opportunity of the Great Recession to bring about a green transformation to sustain all peoples, especially those most distressed? ARC provides the tools. We must act together to demand equity in the recovery, green or otherwise.

Photo taken by Jacob Ruff at the Mobilization for Climate Justice protest against Chevron in Richmond, California.

* A Tale of Two Cities by Charles Dickens.

Billionaires for Wealthcare toasted the rightwing demonstrators that gathered in DC this past weekend to protest healthcare reform, legislation to stave off climate change, and all attempts to provide a safety net for working families and folks of color.

They describe themselves as “a grassroots network of health insurance CEOs, industry lobbyists, talk-show hosts, and others profiting off of our broken health care system. We are not a political, religious or even particularly well-organized group. We’re simple folk, thrilled profiteers pouring out of our corner offices to dance on the grave of ‘Change.’ We’ll do whatever it takes to ensure another decade where your pain is our gain. After all, when it comes to healthcare, if we ain’t broke, why fix it?”

See more at their website.

For all of those reasons and one more, I am not satisfied with the conclusions of my last post. The other basis of my frustration? I am not a Hegelian. He of the awful master-slave dialectic, and that terrible “p” word pomos abhor: progress.

Hegel saw the slow, steady rise of mankind as a struggle for freedom — a process that liberated the human spirit and drew the human race forward. This struggle was unavoidable, even as the object was always unattainable-an ideal to be approached, but never achieved.

Hegel thought the old world would be destroyed, and on the ruins would be built the new. This is not dual power or reformism, this is apocalypse followed by transcendence and immanence, then mutation into a different species. It’s like punctuated equilibrium instead of evolution.*

An old world is destroyed as a new one rises, [Hegel] noted-citing the arc that bridges the seed and the fruit, and arc which we call the plant. And noting the curious Vedic legend of the dance of Lord Shiva, who created with one foot and destroyed with the other.

This is evident, argues Harpers blogger Scott Horton, in two misadaptations of Hegel — Marx and neocons. The former, I can see. (Is it not problematic that the man that brought us a labor theory of value and so on, also had a social theory of evolution determined by the mode of production? Marx was very much taken with Lewis Henry Morgan’s book on the “noble savages”, the Iroquois.) The latter, I understand less.

I intend to read Francis Fukuyama and search out a history of the neocons before I write my next post on this subject. An unhappy and hesitant subscriber to certain ideas of Marx I may be. But, no Hegelian.

* I meant to say punctuated equilibrium (evolution by jerks) instead of phyletic gradualism (evolution by creeps).

I was too afraid to ask for a sample.

I have nothing intelligent to say about today’s primary. When it comes to electoral politics, I am totally clueless, unable to interpret or even predict wisely. I know that the Democrats are deciding today between a woman and black man as their candidate. Who will be the most appealing for the vast red-state country, sick of a declining economy and a cheap talking president who leaves a stinking pile of steaming deficit behind?

I wish I could point to Obama and say, “he’s the man, because…” but, honestly, what does the man stand for? For “change”, and then what?

Paul Krugman says the only substantive difference between Hillary and Obama is their stance on individual mandates in health care reform: the former for, and latter against. I’m mixed about this: our healthcare system is broken; politically, I have a real problem with the onus of healthcare moving from the backs of the state to the shoulders of the individual, and ultimately the pockets of private insurance companies.

David Leonhardt this Sunday looked at Obama’s economic platform, and places him slightly to the left of Clinton but firmly within the center of the Democrat party:

He has called for shoring up Social Security by raising payroll taxes on very high earners, while she has not. He also favors a permanent tax credit of up to $1,000 for families in the bottom 90 percent or so of the income distribution, which makes his package of middle-class tax credits significantly larger than hers.

Obama’s economic advisers come from a school known as “behavioral economics” which tries to reduce the opaque bureaucracy and mystifying jargon of policy into lay terms.

Mr. Obama sometimes talks about an “iPod government” that can achieve its aims by presenting choices more simply.

Obama, the iPod generation candidate. Simplifying for us the complicated. But simple is meaningless if there’s no substance. We won’t be satisfied with just a sweet lingering taste from a brick of cheese. Step up, and give us something real to chew on.

Sighted at the Fairway Market in Red Hook, Brooklyn on January 26, 2008.